title: Pediatric providers' attitudes toward retail clinics.
abstract: OBJECTIVE
  To describe pediatric primary care providers' attitudes toward retail clinics and their experiences of retail clinics use by their patients.
  
  
  METHODS
  A 51-item, self-administered survey from 4 pediatric practice-based research networks from the midwestern US, which gauged providers' attitudes toward and perceptions of their patients' interactions with retail clinics, and changes to office practice to better compete.
  
  
  RESULTS
  A total of 226 providers participated (50% response). Providers believed that retail clinics were a business threat (80%) and disrupted continuity of chronic disease management (54%). Few (20%) agreed that retail clinics provided care within recommended clinical guidelines. Most (91%) reported that they provided additional care after a retail clinic visit (median 1-2 times per week), and 37% felt this resulted from suboptimal care at retail clinics "most or all of the time." Few (15%) reported being notified by the retail clinic within 24 hours of a patient visit. Those reporting prompt communication were less likely to report suboptimal retail clinic care (OR 0.20, 95% CI 0.10-0.42) or disruption in continuity of care (OR 0.32, 95% CI 0.15-0.71). Thirty-six percent reported changes to office practice to compete with retail clinics (most commonly adjusting or extending office hours), and change was more likely if retail clinics were perceived as a threat (OR 3.70, 95% CI 1.56-8.76); 30% planned to make changes in the near future.
  
  
  CONCLUSIONS
  Based on the perceived business threat, pediatric providers are making changes to their practice to compete with retail clinics. Improved communication between the clinic and providers may improve collaboration.
authors.affiliation: Washington University in St Louis, St Louis, MO. Electronic address: jgarbutt@dom.wustl.edu.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Garbutt
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Mandrell
authors.forename: Randall
authors.initials: R
authors.lastname: Sterkel
authors.forename: Jay
authors.initials: J
authors.lastname: Epstein
authors.forename: Kristin
authors.initials: K
authors.lastname: Stahl
authors.forename: Katherine
authors.initials: K
authors.lastname: Kreusser
authors.forename: Harold
authors.initials: H
authors.lastname: Sitrin
authors.forename: Adolfo
authors.initials: A
authors.lastname: Ariza
authors.forename: Evelyn Cohen
authors.initials: EC
authors.lastname: Reis
authors.forename: Robert
authors.initials: R
authors.lastname: Siegel
authors.forename: John
authors.initials: J
authors.lastname: Pascoe
authors.forename: Robert C
authors.initials: RC
authors.lastname: Strunk
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003132:Commerce; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D057240:Patient Preference; D010372:Pediatrics / Q000458:organization & administration*; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
keywords: AAP; American Academy of Pediatrics; PBRN; Practice-based research network; REDCap; Research electronic data capture; WU PAARC; Washington University Pediatric and Adolescent Ambulatory Research Consortium